Wilson C B, Gutin P, Boldrey E B, Drafts D, Levin V A, Enot K J
Arch Neurol. 1976 Nov;33(11):739-44. doi: 10.1001/archneur.1976.00500110007002.
Identification of effective single chemotherapeutic agents for brain tumors must precede the rational use of multiple drug combinations. In phase 2 trials beginning in 1968, 158 patients with intrinsic brain tumors (mostly recurrent malignant astrocytomas) were considered evaluable. The larger trials with more effective drugs produced these results: carmustine (BCNU) response rate, 47%, with median duration of nine months; lomustine (CCNU), 44%, with median duration of six months; procarbazine hydrochloride, 52%, with median duration six months; carmustine and vincristine sulfate combined, 44%, with median duration of only four months; and BIC (5-[3,3-bis(2-chloroethyl)-1-triazeno]imidazole-4-carboxamide), 38%, with median duration of five months. Administration of glucocorticoids was not found to bias the frequency of response. Forty-seven patients, 26 of whom had responded to the initial drug, received a second drug. Among 26 patients who were evaluable, only four responded to the second drug.
在合理使用多种药物联合治疗之前，必须先确定对脑肿瘤有效的单一化疗药物。从1968年开始的2期试验中，158例原发性脑肿瘤患者（大多为复发性恶性星形细胞瘤）被认为可进行评估。使用更有效药物的大型试验得出了以下结果：卡莫司汀（BCNU）的缓解率为47%，中位持续时间为9个月；洛莫司汀（CCNU）为44%，中位持续时间为6个月；盐酸丙卡巴肼为52%，中位持续时间为6个月；卡莫司汀与硫酸长春新碱联合使用为44%，中位持续时间仅为4个月；以及BIC（5-[3,3-双（2-氯乙基）-1-三氮烯]咪唑-4-甲酰胺）为38%，中位持续时间为5个月。未发现使用糖皮质激素会影响缓解频率。47例患者接受了第二种药物治疗，其中26例对初始药物有反应。在可评估的26例患者中，只有4例对第二种药物有反应。
